Management of Gynecological Cancer Patients Older than 70 Years of Age

Abstract

s u m m a r y Background: The incidence of geriatric oncology patients has not been studied very well. A retrospective study of the incidence of geriatric patients with malignant gynecological disease is therefore presented. Patients and methods: From 1982 until 2006, a total of 8377 patients with gynecological malignancies were treated in our clinic, 834 (10%) of whom were aged 70 years. In the analysis, annual reports of the clinic were used and the personal histories of patients aged 70 years (834 patients) were analyzed. The statistical method used was Fisher's exact test. Results: The number of patients aged 70e74 years, 75e79 years, and 80 years were 528 (63.3%), 215 (25.8%), and 91 (10.9%), respectively. Endometrial cancer was detected in 240 cases (28.77%), ovarian cancer in 192 cases (23.02%), vulvar cancer in 180 cases (21.58%), cervical cancer in 169 cases (20.26%), uterine sarcoma in 37 cases (4.43%), and vaginal cancer in 16 cases (1.91%). The comorbidities included were hypertension, diabetes, cardiovascular disease, pulmonary disease, and cerebrovascular disease. Operation was performed in 655 cases (78%), radiation therapy only in 152 cases (18%), and chemotherapy only in 27 cases (3%). In the present study, the in-hospital complication rate occurred in 78 cases (9.3%). In the group of patients aged >80 years, the in-hospital complication rate occurred in 20 cases (21%). No case of death related to surgery occurred. Conclusion:The key in choosing the treatment therapy is the localization and the stage of the cancer, whereas patient age and different chronic diseases are relevant to the treatment strategies used. The cases of geriatric gynecological malignancies were treated following the same guidelines used for younger patients. An increase in elderly surgical cancer workload is inevitable in the coming years. The special needs of elderly cancer patients should be taken into consideration prior to treatment planning.

Clinical Factors Associated with Longer Hospital Stay Following Ovarian Cancer Surgery

“…Our investigation has identified an association between longer LOS and several clinical factors following surgery for ovarian cancer, some of which can be potentially impacted by medical or surgical decisions. OC is a disease of older women who frequently have numerous medical comorbidities like hypertension, diabetes mellitus, cardiovascular disease, and pulmonary disease [23,24]. Women generally present with advanced and disseminated cancer which is commonly associated with weight loss, severe malnutrition, and impaired gastrointestinal function, which can contribute to a protracted surgical recovery, and prolonged hospitalization [25].…”

Short‐term surgical complications after radical hysterectomy—A nationwide cohort study

“…Moreover, chronic pulmonary disease and vascular disease have been reported as predictors of perioperative and postoperative complications in gynecological cancer. [16][17][18][19][20][21][22] Timing of radical hysterectomy after a previous diagnostic procedure was reported to be a predictor of developing complications. 9 Receiving early (ie ≤6 weeks after diagnostic excision) radical hysterectomy was associated with more complications, because of a hypothesized impact of parametrial inflammation, than receiving delayed radical hysterectomy.…”

Palliative treatment of endometrial cancer type 1 in elderly women with Anastrozole.

“…Nevertheless, the rate of surgery in patients aged more than 80 years is similar of the one stated in younger women [22]. Any possible complications of surgical procedure in older women decrease their quality of life, especially in women with several comorbidities [23].…”